Homestead_Woolems SLUE FORM !RU■•1 TREASURER FORM?51A
.VIntO BY RATE MVN OF AMA 1NTS.]nor IIIMMIIED BY fir DEPA Tetr OF LOCAL GOVERNMENT rn:ANCE IC 6-1.1-224.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1343-1609 requires Taxpayers who receive the homestead standard deduction to verify that they are eligible to incise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.Ibis information will he kepi conlldential and ran only be accessed by authorized county officials.The Department of
Local Government finance will use this infomsation to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Woolems, Rebecca A
7923 S Andre In
FORT BRANCH IN 47648
2986
Rebecca A Woolems
7923 S Andee Lane State Parcel Number Legal Description
FORT BRANCH IN 47648-1548
26-19-19-103-001.203-026 SOUTHGATE 17
liltIIIttiltilrnllI11111Ilu111111u1D1111111111ItIll!It11,1
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�ec()� `-1/luu 00/PAS
• Addr (number and street itv,state,and ZIP code) n Same as property address
/ 23 . :71tidy Lau rf lSQ ugh u-2(ota
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) n Same as property address
Social Security Number(last 5 digits) Drieer's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
PART 3i CERTIFICATION
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
�enature Date
%�
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
smro F«m srra (�ts i am�
Presumed by tAe DeVa(trro�rt d Local (3mbmnant Fmarxe
INSTRUCTIONS: See rovsme eidi la�np tresbucflorta
�
/ '� FORM
NC10
YEAR
I(We) �.Q�.i�/i%i%(tii /L-"� �4%Q�.�%i��� �' certi(�iQiv �ett� �t1HO' ot March, 20_
I(We) occupied as our principal place of residence the foliowing described real property (or which a Homestead Property Tac Credit is hereby daimed:
❑ I (VJe) owned ❑ !ve buying under contrad `�'j/ � �
v<
� Have a benefidal interest in the entity that is liable for the property laxes on the property and that owG� the��pg��i5{b J�,��r a convaIX.
BS
I( biry4g on conVact, Fee Simple ownefs name
Recorders ofica whera co�Gad
Couny
Tamship
�y� Legal dea
7'l�/ � /
H any portion W Ne residential strucWre w the land nd axceeding
of Ne Dropert� utii'¢ed W prroduce Inmma.
Remrd number � Page
Tating Aistrict , town, tawnshiP)
I� Is the pro in estion:
eai woPOM ❑ Moblle Homo (I.C. &1.1-� .
� arre that immediatety wrrounds thet sLUGUre Ls used b produce inoome, desaihe Me use antl portbn
__— — � � � �r��:��
' � ' //�nI1
20_Pay20_
Lesser d 1�2 Homestead
V9ueLOn orf35.000
Sgnature oh'�
$
�